18 Questions
Which anticholinesterase drug is used orally every 6 hours in the treatment of myasthenia gravis?
Pyridostigmine
What is the main use of edrophonium due to its very short duration of action?
Diagnosis of myasthenia gravis and differentiation between cholinergic and myasthenic crises
Which anticholinesterase drug is used topically in the treatment of glaucoma once or twice a week?
Demecarium
Which anticholinesterase drug is used in the treatment of Alzheimer's disease and can cross the blood-brain barrier?
Rivastigmine
Which anticholinesterase drug is primarily used for enhancing recovery from the effects of competitive neuromuscular blockers after surgery when given intravenously or intramuscularly?
Edrophonium
Which anticholinesterase drug is specifically used for differentiating between cholinergic and myasthenic crises by observing patient response?
Edrophonium
What is the main reason why tacrine is rarely used nowadays?
Hepatotoxic effect
Which type of anticholinesterase compounds are highly lipid soluble except for echothiophate?
Organophosphorus compounds
What is one of the therapeutic uses of DFP and echothiophate?
Treatment of glaucoma
In organophosphorus poisoning, what are the main muscarinic effects observed?
Marked miosis, ciliary spasm, conjunctival congestion
Which clinical effect of organophosphorus poisoning affects the neuromuscular junction of skeletal muscles?
Weakness, muscle fatigueability
Which of the following is NOT a therapeutic use of organophosphorus compounds?
Treatment of hypertension
How does neostigmine act in the treatment of myasthenia gravis?
By enhancing ACh at nicotinic sites
What is a common method to control the muscarinic side effects of neostigmine?
Using atropine
In patients with ocular myasthenia, which drug can be used alone as a treatment?
Neostigmine
What is a potential treatment option for patients with wide-spread muscle weakness due to myasthenia gravis?
Oral pyridostigmine every 6h
What is the antidote for respiratory paralysis caused by an overdose of competitive neuromuscular blockers?
Atropine
For what purpose is neostigmine nasal spray currently being trialed?
To prevent respiratory arrest caused by snake venoms
Study Notes
Anticholinesterase Drugs
- Pyridostigmine is used orally every 6 hours to treat myasthenia gravis.
Edrophonium
- Edrophonium has a very short duration of action, making it mainly used to differentiate between cholinergic and myasthenic crises by observing patient response.
Glaucoma Treatment
- Echothiophate is used topically in the treatment of glaucoma, typically given once or twice a week.
Alzheimer's Disease
- Donepezil is used to treat Alzheimer's disease and can cross the blood-brain barrier.
Neuromuscular Blockers
- Neostigmine is primarily used to enhance recovery from the effects of competitive neuromuscular blockers after surgery when given intravenously or intramuscularly.
Tacrine
- Tacrine is rarely used nowadays due to its hepatotoxicity.
Lipid Solubility
- Quaternary anticholinesterase compounds are not lipid soluble, except for echothiophate.
Therapeutic Uses
- DFP (diisopropyl fluorophosphate) and echothiophate are used to treat glaucoma.
Organophosphorus Poisoning
- Muscarinic effects observed in organophosphorus poisoning include bronchoconstriction, increased salivation, and bradycardia.
- Organophosphorus poisoning affects the neuromuscular junction of skeletal muscles, leading to muscle weakness or paralysis.
- Herbicides are not a therapeutic use of organophosphorus compounds.
Myasthenia Gravis Treatment
- Neostigmine acts in the treatment of myasthenia gravis by increasing the amount of acetylcholine available at the neuromuscular junction.
- Muscarinic side effects of neostigmine can be controlled with atropine.
- In patients with ocular myasthenia, neostigmine can be used alone as a treatment.
- Plasmapheresis is a potential treatment option for patients with wide-spread muscle weakness due to myasthenia gravis.
Respiratory Paralysis
- Neostigmine is the antidote for respiratory paralysis caused by an overdose of competitive neuromuscular blockers.
Neostigmine Nasal Spray
- Neostigmine nasal spray is currently being trialed for the treatment of concussion.
Test your knowledge on cholinesterase inhibitors such as Pyridostigmine, Ambenonium, and Edrophonium. Learn about their similarities, differences, and usage in conditions like myasthenia gravis and cholinergic crisis.
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